The marginal artery of Drummond revisited: A systematic review

Mann, Mitchell R; Kawzowicz, Michal; Komosa, Alexander J.; Sherer, Yael M.; Łazarz, Dominik P.; Loukas, Marios; Tubbs, R. Shane; Pasternak, Artur

doi:10.1016/j.tria.2021.100118

Cited by 18 publications

(19 citation statements)

References 34 publications

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“…It is important to note that communicating arteries exist between the superior and inferior mesenteric arteries (IMA), allowing for multiple pathways of blood supply to the bowel. The major anastomotic network between distal branches of the SMA and IMA is known as the marginal artery of Drummond, while a proximal anastomosis between the middle colic artery (SMA branch) and the left colic artery (IMA branch) is known as the arc of Riolan or meandering artery [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Sayegh

Medina

Riva

et al. 2023

JCM

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Injury to the superior mesenteric artery (SMA) is a rare, underreported, and potentially devastating complication. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. Three different instances of intraoperative injury to the SMA are described in an accompanying video. All three occurred when the SMA was misidentified as the left renal artery during left robotic radical nephrectomy. In the first case, the SMA was mistakenly identified as the renal artery, but after further dissection, the real renal artery was identified and SMA injury was prevented. In the second case, the SMA was clipped and the real left renal artery was subsequently identified, requiring clip removal. In the third case, the SMA was clipped and completely transected, requiring prompt repair by vascular surgery with a successful outcome. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. The proper anatomic recognition of the SMA may prevent its injury. Intraoperative SMA injury should be promptly identified and repaired to avoid its devastating consequences.

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Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Sayegh

Medina

Riva

et al. 2023

JCM

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“…This allowed the surgeon to modify the resection margin and to carry on the surgical procedure. Given the existing high variability within the inferior mesenteric artery district, in particular concerning the course and presence of the marginal artery of Drummond or the arc of Riolan [ 30 , 31 ], we hypothesized that, in these four patients, both vascular structures were either absent or inadvertently damaged during the procedure, or impaired due to the presence of an atherosclerotic disease. Nonetheless, in these particular cases, the intraoperative use of HSI represented an added value and allowed performing the anastomosis in a well-perfused area, possibly preventing a potential AL.…”

Section: Discussionmentioning

confidence: 99%

Border Line Definition Using Hyperspectral Imaging in Colorectal Resections

Jansen-Winkeln

Dvorak

Köhler

et al. 2022

Cancers

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Background: A perfusion deficit is a well-defined and intraoperatively influenceable cause of anastomotic leak (AL). Current intraoperative perfusion assessment methods do not provide objective and quantitative results. In this study, the ability of hyperspectral imaging (HSI) to quantify tissue oxygenation intraoperatively was assessed. Methods: 115 patients undergoing colorectal resections were included in the final analysis. Before anastomotic formation, the bowel was extracted and the resection line was outlined and imaged using a compact HSI camera, in order to provide instantaneously quantitative perfusion assessment. Results: In 105 patients, a clear demarcation line was visible with HSI one minute after marginal artery transection, reaching a plateau after 3 min. In 58 (55.2%) patients, the clinically determined transection line matched with HSI. In 23 (21.9%) patients, the clinically established resection margin was entirely within the less perfused area. In 24 patients (22.8%), the HSI transection line had an irregular course and crossed the clinically established resection line. In four cases, HSI disclosed a clinically undetected lesion of the marginal artery. Conclusions: Intraoperative HSI is safe, well reproducible, and does not disrupt the surgical workflow. It also quantifies bowel surface perfusion. HSI might become an intraoperative guidance tool, potentially preventing postoperative complications.

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“…3). 17,18 However, there is no consensus on whether high-tie versus low-tie vascular transections should be used. [3][4][5][6][7][8][9][10][11]19 Some authors argue that high ligation enables complete lymph node resection, improving staging of the surgical specimen and making it a better approach from an oncological viewpoint, and that it provides greater mobility of the colon and thus facilitates the creation of an anastomosis by reducing tension.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Computed Tomography Angiography in the Preoperative Workup of Patients With Colorectal Cancer

Canedo-Antelo

García‐Figueiras

Quintero-Rivera

et al. 2022

J Comput Assist Tomogr

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ObjectivesThe objective of this study is to analyze the main patterns of branching of the inferior mesenteric artery (IMA) and to determine if your knowledge changes the surgical strategy in the colorectal cancer.MethodsThis retrospective study included 63 patients with cancer of the sigmoid or rectum. We assessed the patterns of IMA in 3 subtypes: type A (independent left colic artery [LCA]), type B (LCA and sigmoid artery arising in a common trunk) and type C (LCA, sigmoid artery, and superior rectal artery with a common origin). Colorectal surgeons evaluated how the vascular map changed the type of IMA ligation.ResultsInferior mesenteric artery branching was classified as type A in 55.6% patients, type B in 23.8%, and type C in 20.6%. Knowledge of the vascular map changed the type of ligation from high to low in 20 of the 50 patients who were candidates for surgery. The change was possible in tumors located in the sigmoid colon and the rectosigmoid junction with the type A or B branching.ConclusionsPreoperative Multidetector Computed Tomography angiography can define the pattern of IMA branching. Based on this information, a low ligation can be performed in tumors located in sigmoid colon and rectosigmoid junction with IMA branching types A and B.

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The marginal artery of Drummond revisited: A systematic review

Cited by 18 publications

References 34 publications

Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Border Line Definition Using Hyperspectral Imaging in Colorectal Resections

Usefulness of Computed Tomography Angiography in the Preoperative Workup of Patients With Colorectal Cancer

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